Subcutaneous Versus Sublingual Immunotherapy for Adults with Allergic Rhinitis: A Systematic Review with Meta‐Analyses

Tie, Kevin; Miller, Craig; Zanation, Adam M.; Ebert, Charles S.

doi:10.1002/lary.29586

Cited by 20 publications

(12 citation statements)

References 69 publications

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“…Although there is no direct evidence that AIT is as effective as pharmacotherapy as a primary treatment for AR, most RCTs evaluating the efficacy of SLIT or SCIT showed improvement in symptoms and/or medication requirement compared to placebo. One caveat to these studies is the fact that patients in the placebo groups were allowed to use allergy medications and were essentially a pharmacotherapy treatment group rather than a true placebo group 2421,2422 …”

Section: Managementmentioning

confidence: 99%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

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157

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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Section: Managementmentioning

confidence: 99%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

Self Cite

157

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“…Shorter up‐dosing schedules such as 7‐injection or 11‐injection schedules have also been developed 98 . Comparative studies between the SCIT and SLIT in terms of effectiveness, safety, and cost‐effectiveness are limited, and the results are difficult to interpret 99–101 . Shamji et al 102 have indicated that blocking the activity of the IgE–allergen complex binding to B cells had similar effects to SLIT and SCIT, while specific IgA production was increased after SLIT and IgG4 production was increased following SCIT.…”

Section: Mechanism‐oriented Treatmentmentioning

confidence: 99%

“…98 Comparative studies between the SCIT and SLIT in terms of effectiveness, safety, and cost-effectiveness are limited, and the results are difficult to interpret. [99][100][101] Shamji et al 102 have indicated that blocking the activity of the IgE-allergen complex binding to B cells had similar effects to SLIT and SCIT, while specific IgA production was increased after SLIT and IgG4 production was increased following SCIT. Thus, more head-to-head studies are needed to investigate the differences between SLIT and SCIT, which may aid in selection of a personalized therapy method.…”

Section: Subcutaneous Immunotherapy (Scit) and Sublingual Immunothera...mentioning

confidence: 99%

Update on pathomechanisms and treatments in allergic rhinitis

Zhang

Feng

Zhang

2022

Allergy

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Allergic rhinitis (AR) is a global health problem with increasing prevalence and association with an enormous medical and socioeconomic burden. New recognition of immune cells such as type 2 innate lymphocytes (ILC2s), T helper (Th2) 2 cells, follicular helper T cells, follicular regulatory T cells, regulatory T cells, B cells, dendritic cells, and epithelial cells in AR pathogenesis has been updated in this review paper. An in‐depth understanding of the mechanisms underlying AR will aid the identification of biomarkers associated with disease and ultimately provide valuable parameters critical to guide personalized targeted therapy. As the only etiological treatment option for AR, allergen‐specific immunotherapy (AIT) has attracted increasing attention, with evidence for effectiveness of AIT recently demonstrated in several randomized controlled trials and long‐term real‐life studies. The exploration of biologics as therapeutic options has only involved anti‐IgE and anti‐type 2 inflammatory agents; however, the cost‐effectiveness of these agents remains to be elucidated precisely. In the midst of the currently on‐going COVID‐19 pandemic, a global life‐threatening disease, although some studies have indicated that AR is not a risk factor for severity and mortality of COVID‐19, this needs to be confirmed in multi‐centre, real‐life studies of AR patients from different parts of the world.

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“…Di Bona et al [ 19 ] state that a small benefit of sublingual grass allergen immunotherapy in reducing the symptoms is shown, although the low magnitude of the benefit and the easy administration of sublingual allergen immunotherapy are not enough reasons for the choice of SLIT. Tie et al [ 20 ] performed an indirect comparison of subcutaneous allergen immunotherapy vs sublingual allergen immunotherapy and concluded that both treatment options are comparably effective treatments for adults with allergic rhinitis and allergic conjunctivitis. Radulovic et al [ 21 ] performed a Cochrane meta-analysis.…”

Section: Reviewmentioning

confidence: 99%

House Dust Mite and Grass Pollen Allergen Extracts for Seasonal Allergic Rhinitis Treatment: A Systematic Review

Sialakis¹,

Sialaki²,

Frantzana³

et al. 2022

Cureus

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Background: The treatment of allergic rhinitis is important due to the burden that the disease causes globally. The objective of this review is to explore the efficiency of house dust mite and grass pollen extracts in allergic rhinitis treatment.Methods: We performed research in electronic databases and searched relevant articles on PubMed, CINAHL, OVID, ScienceDirect, Cochrane CENTRAL, and MEDLINE. We used keywords such as 'allergic rhinitis', 'sublingual immunotherapy', 'randomized controlled trials', 'grass pollen', 'allergen immunotherapy', and 'house dust mite'. We included nine randomized controlled trials (RCTs). Quality assessment of included studies was performed independently by two authors.Results: We included nine eligible RCTs in this review. Five RCTs were about grass pollen extracts and four RCTs were about house dust mite extracts. Most of the studies reported positive results and suggested further evaluation of sublingual immunotherapy (SLIT) treatment. Grass pollen extracts mostly used were Dactylis glomerata, Poa pratensis, Lolium perenne, Anthoxanthum odoratum, Phleum pratense, and Parietaria. House dust mite extracts used were from Dermatophagoides pteronyssinus and Dermatophagoides farina. According to the quality assessment, no bias was observed in the included studies.Conclusions: Although sublingual allergen immunotherapy shows a benefit compared to placebo in the treatment of allergic rhinitis and rhino-conjunctivitis in adults, the results are interpreted with caution due to the high heterogenicity among studies in treatment protocols and dosing. More standardization among studies is needed.

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Subcutaneous Versus Sublingual Immunotherapy for Adults with Allergic Rhinitis: A Systematic Review with Meta‐Analyses

Cited by 20 publications

References 69 publications

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Update on pathomechanisms and treatments in allergic rhinitis

House Dust Mite and Grass Pollen Allergen Extracts for Seasonal Allergic Rhinitis Treatment: A Systematic Review

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